胎盘前置状态引产中子宫动脉栓塞术介入时机探讨  

Timing of uterine artery embolization in induced labor with placenta previa.

作　　者：施隽 李文霞[1] 胡科[1] 李文中 李铁平 SHI Jun;LI Wen-xia;HU Ke(Department of Obstetrics,Changsha Hosplital for Matemal and Chlid Health Care,Changsha Hunan 410011,China.)

机构地区：[1]长沙市妇幼保健院产科,湖南长沙410011

出　　处：《临床和实验医学杂志》2021年第17期1884-1887,共4页Journal of Clinical and Experimental Medicine

基　　金：湖南省卫生计生委科研计划课题自助项目(编号:B2016232)。

摘　　要：目的探讨胎盘前置状态引产中子宫动脉栓塞术介入的时机。方法采用回顾性研究方法,选取2019年2月至2021年4月在长沙市妇幼保健院就诊的胎盘前置状态引产妇女43例,根据子宫动脉栓塞术介入情况分为A组(n=23)和B组(n=20),其中A组为药物引产前给予子宫动脉栓塞术介入,B组为临产或出现阴道流血时行子宫动脉栓塞介入。观察2组引产成功率、产时出血量、产后2 h出血量和引产时间;比较2组输血治疗比率;记录2组术后卵巢血供参数[收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)]、凝血指标[D-二聚体(D-D)、凝血酶原时间(PT)和活化部分凝血酶时间(APTT)]。结果A组引产成功率为100.00%,明显高于B组(80.00%),而产时出血量、产后2 h出血量和引产时间分别为(1120.06±225.51)mL、(150.06±32.21)mL、(48.42±11.03)h,明显低于B组[(1980.45±341.17)mL、(266.78±28.84)mL、(57.79±10.85)h],差异均有统计学意义(P<0.05)。A组和B组输血治疗比率比较(13.04%vs.10.00%),差异无统计学意义(P>0.05)。A组术后1周卵巢PSV、EDV分别为(37.78±8.22)、(11.05±2.65)cm/s,明显高于B组[(33.56±7.80)、(9.55±2.41)cm/s],而RI为0.79±0.10,明显低于B组(0.84±0.12),差异均有统计学意义(P<0.05)。A组和B组术后24 h时APTT、PT和D-D比较,差异均无统计学意义(P>0.05)。A组和B组并发症发生率比较,差异无统计学意义(P>0.05)。结论在胎盘前置状态引产中,药物引产前给予子宫动脉栓塞术介入有较好的效果,值得临床使用。Objective To investigate the timing of uterine artery embolization in induced labor with placenta previa.Methods A retrospective study was conducted,43 cases of induced labor women with placenta previa in Changsha Hosplital for Matemal and Chlid Health Care from February 2019 to January 2021 were selected,were divided into group A(n=23)and group B(n=20)according to the interventional situation of uterine artery embolization.Group A was given uterine artery embolization before drug induced labor,group B was given uterine artery embolization during labor or vaginal bleeding.The success rate of labor induction,the amount of bleeding during delivery,the amount of bleeding in 2 h postpartum and the time of induction of labor in the two groups were observed;the hysterectomy rates of the two groups were compared;postoperative ovarian blood supply parameters[peak systolic blood flow velocity(PSV),end-diastolic blood flow velocity(EDV),resistance index(RI)],coagulation index[D-dimer(DD),prothrombin time(PT)and activated partial thrombin time(APTT)]of two groups were recorded.Results The success rate of induced labor in group A was 100.00%,which was higher than that in group B(80.00%),while the amount of intrapartum blood loss,2 h postpartum blood loss and induced labor time were(1120.06±225.51)mL,(150.06±32.21)mL and(48.42±11.03)h,which were lower than those in group B[(1980.45±341.17)mL,(266.78±28.84)mL and(57.79±10.85)h],the differences were statistically significant(P<0.05).Compared with the blood transfusion treatment rate of group A and group B(13.04%vs.10.00%),the difference was not statistically significant(P>0.05).The PSV and EDV in group A at 1 week after operation were(37.78±8.22)and(11.05±2.65)cm/s,which were higher than those in the group B[(33.56±7.80),(9.55±2.41)cm/s],and the resistance index(RI)was 0.79±0.10,which was lower than that in the group B(0.84±0.12),the differences were statistically significant(P<0.05).There was no significant difference in APTT,PT and D-D between group A and group B

关 键 词：胎盘前置状态 子宫动脉栓塞介入 引产 临床效果 

分 类 号：R719.3[医药卫生—妇产科学]